Things You Need To Know About Being Induced
Things You Need To Know About Being Induced

Things You Need To Know About Being Induced

If you’re pregnant, you may be wondering what will happen if things don’t go according to plan during labour. With over a third of all pregnancies in the UK leading to an induction, we went to the experts to find out more.
Photography: NINA ZIVKOVIC/STOCKSY UNITED
Photography: NINA ZIVKOVIC/STOCKSY UNITED

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First – Why Might You Need To Be Induced?

“Labour induction means creating contractions in the uterus before labour starts on its own. In 2020/21, records show 34% of labours were induced (compared to 21% in 2010/11). One of the most common reasons for inducing labour is for women who are still pregnant beyond their due date. NICE (National Institute for Health and Care Excellence) recommends induction of labour for straightforward pregnancies after 41 weeks of pregnancy, although ultimately the decision is down to you. You never have to be induced – it’s a choice. There are other reasons your medical team may offer induction – including if you have pre-eclampsia or gestational diabetes. Induction is also offered if there are concerns about the growth of the baby (either too small or too large), which can be picked up by scans. For around 10% of women, their waters may break before labour starts, and NICE recommends offering induction after 24 hours if labour hasn’t already begun.” – Meghan Roe, expert midwife at Mother Fit

What’s The Earliest You Will Be Induced?

“Outcomes for babies are best when they are born after 39 weeks, so induction before this time will only be offered if there’s a risk to the mother or the baby. People carrying twins or triplets will also be offered induction earlier.” – Meghan 

Are There Things That Happen Before You’re Induced?

“Under NICE guidelines, all women can be offered a membrane sweep after 39 weeks. This involves your midwife or doctor inserting their finger inside the cervix and making a circular 'sweeping' movement on the inside of the cervix to separate the baby's membrane sack from the cervix. Research shows this may reduce the need for formal induction but they do not overall lead to unassisted vaginal births. More research is needed to find out if membrane sweeps are truly beneficial. Make a list of the pros and cons of a membrane sweep to help you make your decision as to whether or not you would like a sweep if offered to you.” – Meghan

There are VARIOUS METHODS of induction, and DIFFERENT hospitals have different GUIDELINES, so it’s not universal.

How Exactly Is Labour Induced – Are There Different Stages?

“There are various methods of induction, and different hospitals have different guidelines, so it’s not completely universal. The medications used to induce labour are called prostaglandins, which promote cervical ripening and encourage the onset of labour. They are administered vaginally in the form of a pessary or a gel. You may receive one or both the pessary/gel during your induction, and sometimes in several doses until you are in labour. Induction of labour is a process, and can take a long time to work. The aim is to kick start your body into labour, so that the contractions can dilate your cervix so you can give birth. Sometimes all you need are the prostaglandins, but sometimes you may need to move onto the next stage of induction if the prostaglandins alone do not help you into active labour. The next stage would be breaking your waters (if not already broken) and starting an artificial oxytocin drip to help the uterus to contract and the cervix to dilate. This stage of induction of labour would be on the labour ward under 1:1 care from a midwife. You’ll also need to be monitored continuously.” – Megan 

If You’ve Given Birth Before, Does This Change Things?

“Yes – if you’ve given birth before, either vaginally or by caesarean section, the balloon catheter method of induction may be offered. This is a mechanical form of induction of labour where a catheter is inserted inside the cervix and filled with saline solution, putting pressure on the cervix, which can encourage the cervix to dilate. This can start labour or it can encourage the cervix to open enough to be able to break the water and start the oxytocin drip.” – Meghan 

How Long Does It Take To Give Birth After Being Induced?

“There’s no guarantee that an induction will work. In fact, sometimes a woman’s body will simply not respond to the drugs and techniques, in which case a caesarean birth is the most likely outcome. It varies enormously how quickly labour will happen after being induced – for some women it may take days, while other women will progress and give birth within 24 hours.” – Tina Perridge, private midwife for Koala & Joe 

“It’s also worth keeping in mind that maternity units can be very busy, and inductions can be delayed or paused if the unit is very busy or under-staffed, which can add significant time onto an induction.” – Meghan 

HANNAH GARVIN/STOCKSY UNITED

Does Being Induced Change The Nature Of Your Labour?

“Induced labour can be more painful than spontaneous labour, so the need for stronger methods of pain relief is more common. We also know that birthing people’s experiences of induced labour compared to spontaneous labour is very different. It may alter your options of place of birth, meaning you may not be able to give birth at home or on a midwife-led unit, and the option of a birthing pool may not be available. An induced labour usually means a longer labour and hospital stay than with spontaneous labour, which can lead to exhaustion.” – Meghan 

What Are The Side Effects Of Induction?

“Evidence shows induction does increase the risk of an instrumental birth, but not a c-section. Sometimes, the medications given to induce labour can cause contractions that are too frequent, which can be painful and put the baby under stress. This is why close monitoring is essential. However, this monitoring can restrict your movement, so ask your midwife about wireless options if available to enable you to remain active (which is known to help with pain and shorten labour). Despite this, it's important to know that a positive induction of labour experience is absolutely possible, and preparation is key. The first step is to ensure you have all the information and evidence you need to make an informed decision that is right for you. Then prepare yourself for a longer hospital stay with items that will make you feel relaxed and comfortable, whether it’s home comforts, snacks, music or a TENS machine.” – Meghan 

INDUCED labour can be more painful than spontaneous labour, so the need for STRONGER methods of PAIN RELIEF is more common.

What Questions Should You Ask Your Midwife Prior To Being Induced?

“It can help to use a simple acronym – BRAIN. B stands for the benefits – what are the benefits to you being induced right now? R stands for the risks involved, while A stands for alternatives – are there any alternatives you can consider? Remember there are always alternatives and the benefits and risks of these should be given. I is for intuition – what is your intuition telling you? And for the ‘N’ – what if the doctors and midwives were to do nothing for an hour, a day, or a week?” – Emiliana Hall, mindful birth teacher and doula, and founder of The Mindful Birth Group 

What Are The Best Natural Ways To Induce Labour?

“In all honesty, labour will start when your body and baby are ready. However, oxytocin is something you can either help or hinder at this stage. It is the hormone that the body produces when it goes into spontaneous labour. It’s the hormone we feel day-to-day when we feel safe, loved, content and unobserved. It also spikes when we are aroused and orgasm. Encouraging this hormone through doing anything you enjoy, from warm baths to movie nights to sex or nipple stimulation, will help to encourage labour in a very gentle but effective way. Food and drink such as raspberry leaf tea and dates are talked about as helping to encourage labour, but without the key ingredient of oxytocin, they’re unlikely to do much. They do however prepare the body – anecdotally they are said to promote a smoother labour, so are great if you enjoy them.” – Emiliana 

“As sperm contains prostaglandin, frequent sex can help, as can colostrum harvesting and being active. Also consider acupuncture and reflexology.” – Tina

If You Want To Learn More About Induction, What Resources Can Help?

“Follow @TheMindfulBirthGroup on Instagram for tips and information around all births, including induction methods. Dr Sara Wickham’s books, including In Your Own Time and Inducing Labour, are also worth a read. Her website also has useful information.” – Emiliana 

“I also recommend Rachel Reed’s Why Induction Matters and websites like MidwifeThinking.com and EvidenceBasedBirth.com. If you’re looking for a podcast, try The Midwives’ Cauldron, The Obs Pod and Evidence Based Birth.” – Meghan 

 

For more information visit MotherFit.co.uk, KoalaAndJoe.com and TheMindfulBirthGroup.com.

 

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